Waging war on cancer, diabetes and clutter one day at a time. Banzai: A Japanese war cry.

Month: January 2015

I’m still coaching basketball and we had a big win today! Then I went to Krav Maga and was happy to hear that they will let me ease back in and then make up my test to move to level 2 when I am recovered from surgery. I’ve been working hard for six months and the level test is only a week after my surgery, so I’ll miss it.

I returned home to find two gifts. My aunt sent two very thoughtful sets of mastectomy pillows with fleece blankets. The little heart shaped pillows fit under my arm to keep pressure off the incision, and will be especially nice for sleeping and riding in the car. They are from JSAW Mastectomy Designs and are very pretty colors and patterns. She also included a prayer cloth from her church and some cash (hello Kindle Unlimited subscription). Thank you Aunt S and family!

I also had mail from The Cancer Card Xchange (CCX). CCX is a fantastic charity run by my neighbor, Emily. She is a cancer survivor herself and started a charity that provides gift cards to cancer patients and their families. Some to help meet basic needs and others just to brighten up their day. I loved opening the envelope to find a card for a pedicure and a family trip to the movies!

I just looked up and realized I still have Christmas wreathes on the front doors.

In the past three weeks I’ve forgotten my keys, gotten to work but my computer was left at home, locked myself out of the house, left a flatiron plugged in, forgotten meetings, my daughter’s tests and homework, took my kids to school late today and made it there before I realized my son didn’t have a coat. At least he had shoes.

Did you know that cancer patients are, above all things a project manager? Like a general contractor, I need to find subcontractors and schedule their work. Surgeon, plastic surgeon, anesthesiologist, endocrinologist and the list goes on and on. I make appointments, order supplies and plan every day. I follow up to make sure that things happen.

Last night I hosted a conference call with my breast surgeon, plastic surgeon, my husband and me. We went over two pages of questions I had about surgical options, diabetes management during surgery and general questions I had about recovery. I was able to get answers and also confirm that they were both on the same page. It was a great call and at the end I felt like all four of us agreed on the same surgical and reconstructive choice.

I felt like a huge burden had been lifted and I’m actually excited to know what is going to happen. The uncertainty has been the worst part for me so far. It is tempered by the fact that I’m doing something so final and permanent, though.

So I repeat what has been my mantra for two weeks, “I am lucky. It could be so much worse. I don’t need breasts to live, and they can be replaced. It won’t be the same but it will be good enough. They have done good work in the past but have betrayed me and it’s time to let them go. I don’t trust them any more. This is a temporary problem and everything will be fine.”

That morning they will inject dye and a radioactive tracer into my right breast, which is anecdotally quite painful. Then the dye and tracer will seep through the lymphatic system in my breast and they will use it to identify the first layer of lymph nodes that catch the dye/tracer. Those are considered the sentinel nodes and will be removed during surgery and biopsied. Typically it’s about 1-6 nodes but I’m praying it’s only 1-2 for me. The more nodes that get removed, the greater chance of lymphadema aka freakish arm swelling.

In the afternoon I’ll have a skin-sparing bilateral mastectomy with Dr P and Dr A will create pockets in my chest muscles and put in “inflatable” expanders in preparation for silicone implants that will be “installed” in a separate surgery in a few months. He will put a little saline in the expander so I won’t be totally flat, and slowly add saline over the next few months until I like the size.

I’m sure that’s more detail then most of you wanted, but blogs like this have
been really helpful for me. Maybe sharing my experience will pay it forward for somebody else.

This morning my husband commented on the lingering bruises and divot in my breast. “That’s gotta go, you know what you want and you just need to schedule it,” he said. “I know what I’m going to do, I’m still talking myself into it,” I replied.

Later I called both Dr P and Dr A to set up a conference call and develop a surgical plan. I’m also looking forward to meeting with the oncologists next week.

At lunch I met with a work colleague who is a survivor and very active in the local BC community. She is so knowledgable, compassionate and kind. While talking to her I got a call with results – BRCA negative! Booya! Pending any calls from the surgeons, I now declare myself cancer free for today. Earliest day yet.

TMI Warning – this post contains lots of talk about things like nipple tattoos. Proceed at your own risk 😉

This morning we met with surgeon #2, Dr P. I really liked her and immediately knew that I want her to do my surgery. She reviewed my case and agreed with everything the previous surgeon said, but also gave me the option of lumpectomy with reconstruction and a big reduction on the left side for symmetry. Then I could get the pathology and make a good informed decision to proceed with a mastectomy if needed.

I loved this idea, and it has been driving me crazy that I don’t really know what is in there. It was also a relief that somebody was considering letting me keep my breasts, however different they would look.

Then I went to see a reconstructive plastic surgeon, Dr A. After his nurse got all my vitals, my husband and I sat in a conference room that looked like a living room. Couches, coffee tables scattered with photo albums of….boobs. And implants to play with. The photos were amazing. I actually understand the value of nipple reconstruction or tattooing now and it was a million times better than internet photos.

Dr A went over all the options with me and I have a lot. All of them are statistically equivalent for eliminating cancer but have varying cosmetic results.

OPTION 1 – LUMPECTOMY + RADIATION + REDUCTION
I can have a right lumpectomy (big, like the size of a Ho-Ho) that includes the nipple and oncoplastic reconstruction where he “puts everything back together pretty” and I’m reduced a couple of cup sizes. Then radiation, which reduces a size or two more and changes my skin texture, wrinkling and toughening it. Then I wait at least 6 months for it to stop shrinking. After 6 months, I would have a reduction on the left side to creat symmetry. It’s a really big reduction, but I’ll still have breast tissue in both sides. And a nipple tattoo if I want, LOL.

OPTION 2 – RIGHT MASTECTOMY + RECONSTRUCTION + REDUCTION
I can have a mastectomy on the right side and reconstruct using a silicone implant. Then I can have a reduction on the left side to match the implant. But then over time the left will be affected by age and gravity and I’ll likely want an additional lift surgery down the road. I’ll still have breast tissue in the left side. And don’t forget the tattoo….

OPTION 3 – BILATERAL MASTECTOMY + RECONSTRUCTION
A bilateral means both sides. It’s a cancer mastectomy on the right, then a prophylactic (preventative) mastectomy on the left. Almost all breast tissue is removed and I’ll be reconstructed with silicone implants, Angelina Jolie style. During the mastectomy Dr A will make a pocket for the implants in my chest muscles and put in expandable implants. Every couple weeks I would go in and have saline injected into the expander to stretch the pocket and skin to the correct size. Then I would have another surgery to exchange the expander for a silicone implant. And again, tattoos.

Another option might be direct to implant instead of the expander if I go really small and don’t need radiation.

Whew. At this point the migraine was starting. I told Dr A I just want them the smallest size that still hides my insulin pump and he laughed with me about it. I’m his first patient to design her breasts around her insulin pump.

Then came topless photos (go ahead and laugh) measurements and more forms. All I do is fill out forms.

Dr A also gave me a fantastic book on breast surgery and reconstruction.

His nurse instructed me to not look at anything cancer related and go home have a normal evening and sleep on it. It was good advice.